Tara Moustis, D.D.S.,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TARA MOUSTIS, D.D.S.,P.C.

Practice address

17037 Oak Park Ave
Tinley Park, IL 60477-2776

Phone

(708) 532-8322

Fax

(708) 532-9210

NPI assigned

Jan 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tara Moustis, D.D.S.NPI 1851449011

Title

President

Phone

(815) 464-8433

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tara Moustis, D.D.S.

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1851449011
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720136989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17037 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772776",
            "telephone_number": "708-532-8322",
            "fax_number": "708-532-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17037 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772776",
            "telephone_number": "708-532-8322",
            "fax_number": "708-532-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA MOUSTIS, D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOUSTIS",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-464-8433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.